Aim: The aim of this study is to determine the accuracy of computed tomography (CT) in assessing local spread of Intrahepatic Cholangiocarcinoma (ICC), and to compare radiological and pathological findings after surgical resection with curative intent.Materials and
Methods: A retrospective study over a period of 36 months was performed involving 28 patients (pts) with diagnosis of ICC.Inclusion criteria: Pts with CT exam before surgery; Pts with radiological diagnosis of ICC that underwent surgical resection with pathological confirmation of malignancy.Exclusion criteria: pts without CT exam before surgery (4pts); surgical exploration with evidence of peritoneal metastases (5pts).A final group of 19 pts was included in this Institutional Review Board (IRB) approved retrospective study.Two independent radiologists retrospectively reviewed CT imaging features with final consensus; imaging analysis included evaluation of: localization; size; presence of satellites nodules; macroscopic type according to Liver Cancer Study Group of Japan criteria (mass-forming (MF) type, periductal infiltrating type (PI), intraductal growth type (IG); hepatic atrophy; vascular invasion (arterial, portal vein or hepatic veins); bile ducts dilatation and infiltration; lymph-nodes involvement.
Results: Localization of ICC was correctly detected in 19/19(100%) pts. Size of the tumor was correctly defined in 18/19(95%) pts. Satellites nodules were correctly detected at CT exam in 6/8(75%) pts and 2 pts with nodules smaller than 2mm weren’t detected. CT showed 14/19(73%) MF type and 4/19(21%) PI type and 1/19(5%) IG type. Whereas at pathological examination of the specimen tunors were classified as MF type in 11/19(57%), as PI type in 5/19(26%) and as IG type in 2/19(10%). Presence or absence of atrophy of hepatic lobe of ICC was correctly detected in 19/19(100%) Pts. Arterial infiltration was correctly detected by CT in 6/7(85%) pts, in 1/7(15%) pts CT didn’t detect the infiltration. Portal vein invasion was correctly detected at TC in 4/4(100%) pts. Hepatic veins invasion was correctly detected at TC in 7/7(100%) . Presence or absence of intra-hepatic bile ducts dilation was correctly detected in 19/19(100%) At pathology bile duct infiltration was present in 9/19(47%) pts, CT correctly detected this features in 8/9(88%). CT detected lymph-nodes suspect for metastases (size > 10mm) in 15/19(79%), whereas pathological examination confirmed positive lymph-node metastases only in 11/19(58%).
Conclusions: CT is a good technique for evaluation of ICC and preoperative fidings are well correlated with surgical and pathological patterns.